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On-line Application Form

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1: Personal details of student
Family name:
First name(s):
 
Title: Gender: Male Female
Date of birth:
Day: Month: Year:
Student's home address:
Nationality:
Student's mobile phone number:
Student's email:
2: Parent or guardian details
Family name:
First name(s):
Title: Gender: Male Female
Relationship to student:
Parent Guardian Agent Other
Please specify:
Parent or guardian's address:
(If different from 1 above)
Home or main phone number:
Mobile phone number:
Other phone numbers (optional):
Fax number:
Main email:
Alternative email:

3: Person responsible for paying fees (if different from 2 above)
Click here to go to next section if the details for this section are the same as section 2
Name:
 
Title: Gender: Male Female
Relationship to student:
Parent Guardian Agent Other
Please specify:
Parent or guardian's address:
(If different from 1 above) 
Main phone number:
Other phone numbers:
Mobile phone number:
Fax number:
Main email:
Alternative email:
4: Contact in an emergency
Name:
Main contact phone number:
Other phone numbers:
Mobile phone number:
5: Course(s) applied for
Subject
(e.g. Maths) 		Level
(e.g. GCSE, AS, A2) 		Proposed Start Date Duration
(e.g. 1 term, 1 year)
As above Or:
As above Or:
As above Or:
As above Or:
As above Or:
As above Or:
As above Or:
6: Educational details
Please list your academic qualifications, English language qualifications should be listed in section 8
Qualifications and subjects Exam board Level and grade

7: Schools/colleges attended (the three most recent)
Please give full details of most recent school below
School:
Dates attended:
From: to:
Contact name:
Position (e.g. head teacher):
School address:
Telephone number:
Fax number:
Email:
Other schools attended
School:
Dates attended:
From: to:
School:
Dates attended:
From: to:
8: For international students only
What is your first language?
What is your second language?
For how many years have you studied English?
English qualifications obtained (most recent only):
Grade/level achieved:
Date your qualification was obtained:
Where did you take the above English qualification?
Do you have a UK student visa?
No Yes
Valid from: to
9: Accommodation
Please select one of the options below:
Room in the COLLEGE BOARDING HOUSE (single room, shared bathroom, self catering)
Host family (breakfast and evening meal provided)
Accommodation not required
10: Health and diet
Does the student have any illnesses, allergies or disabilities requiring special care? No: Yes:
If yes please give further details below:


Mrs Carolyn Owen
Oxford International College
College House
39–42 Hythe Bridge Street
Oxford OX1 2EP
Tel: 01865 203988
Fax: 01865 203998
Email: carolynowen@oxcoll.com